POS1375 THE EVALUATION OF OBESITY IN ADULT-ONSET STILL’S DISEASE, DATA FROM A LARGE MULTICENTRE COHORT.
Authors: I. DI Cola, C. DI Muzio, F. Sensini, R. Giacomelli, P. Cipriani, P. Ruscitti
Journal: Annals of the Rheumatic Diseases (2022)

Background Over the last few decades, obesity has become an increasing public health problem worldwide [1]. This is a complex disease characterised by as an abnormal or excessive fat accumulation which is usually assessed by body mass index (BMI). A value of BMI over 30 identifies the threshold to define the obesity. High BMI is common feature among patients with rheumatic disease and it is associated with higher disease activity and disability [2]. Thus, the presence of obesity may be considered as a negative prognostic factor in these patients. Against this background in rheumatic disorders, the prevalence of obesity in adult onset Still’s disease (AOSD) has not been entirely clarified so far. Similarly, the impact of being obese on disease features and outcomes has not been fully elucidated in these patients. AOSD is a rare inflammatory disease usually characterised by fever, arthritis, and evanescent skin rash associated with a typical hyperferritinemia [3]. Objectives In this study, we aimed at evaluating the prevalence of obesity in patients with AOSD. Furthermore, we descriptively assessed the clinical characteristics of these patients. We also described the occurrence of life-threatening complications, the disease courses, and the rate of mortality of obese patients with AOSD than non-obese ones. Methods A retrospective assessment of prospectively followed patients, from January 2001 to April 2021, was provided to analyse clinical features of patients with AOSD characterised by a BMI≥30. AOSD patients were evaluated among those included in the multicentre Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort. This is a large cohort of patients with AOSD comprising almost 200 patients [4]. The presence of obesity was evaluated at the time of diagnosis of the disease. In this evaluation, only patients with available data about BMI were included. Results In this assessment, 139 patients, who had BMI registered in our database, were evaluated. Out of those, 26 (18.7%) had a BMI≥30 and were defined as having obesity. These patients had a mean age of 39.3±13.6 years and were 46.2% male. Concerning main clinical features, obese patients with AOSD were characterised by fever (96.2%), skin rash (84.6%), arthralgia (76.9%), myalgia (65.4%), and arthritis (61.5%). An explorative comparison between obese and non-obese patients was performed. A lower rate of obese patients showed sore throat (38.5% vs 63.7%, p=0.026) than others. The prevalence of serositis was observed at lower frequency in obese patients with AOSD. Pericarditis (7.7% vs 29.2%, p= 0.024), and pleuritis (7.7% vs 25.7%, p=0.035) were less frequently recorded in obese patients when compared with non-obese ones. In addition, obese patients with AOSD showed higher values of C-reactive protein (CRP) [99.2 (117.0) mg/L vs 52.0 (84.3) mg/L, p=0.046] than others. Conversely, no significant differences were retrieved assessing systemic score, ferritin, erythrocyte sedimentation rate, life-threatening complications, disease patterns, and mortality in obese than non-obese patients. Conclusion Clinical features of obese patients with AOSD were described in our multicentre cohort. Almost 20% of patients with AOSD were obese at the time of diagnosis of the disease. These patients were characterised by a lower prevalence of sore throat, pericarditis and pleuritis, and by higher values of CRP. However, obesity did not appear to influence the main disease features and outcomes in AOSD, although further studies are needed to fully elucidate this issue. References [1]Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-253 [2]Vidal C, et al. J Rheumatol. 2015;42:2261-2269 [3]Giacomelli R, et al. J Autoimmun. 2018;93:24-36 [4]Ruscitti P, et al. Rheumatology (Oxford). 2022 25:keac027 Disclosure of Interests None declared